15 Jan Hip pain
Sir Andy Murray’s ongoing hip injury woes have really put this joint in the spotlight!
The hip was once regarding as a joint that doesn’t really get injured but just wears out as we get older. Thinking back 20 years to when I started training at University, we didn’t really talk much about hips at all. How things have changed!
Over the past ten years there has been a huge rise in the number of people having injuries diagnosed around the hip joint, keyhole surgery increasingly being used to repair damaged tissue and hip replacements being undertaken for younger individuals.
The hip is basically a big ball and socket joint. It is surrounded by thick, strong tissues that help keep it secure and numerous muscles that provide power and control – your buttocks are a complicated group of muscles and not just a cushion to sit on!
The hip joint tends to give pain into the groin area. Pain in the buttock or outer edge of your hip are not normally because of the joint itself but due to the muscles/tendons around the hip, or from your back. The challenge is to work out where the source of the problem is and why it may have occurred. This is not always easy but a skilled physiotherapist experienced in this area can normally find the issue.
Some of the causes of hip/groin pain include:
Muscle strain, tendinopathy
There are many muscles and tendons around the hip and these can become strained due to weakness, tightness, overloading or excessive use. Exercises targeted at the correct area should fix this.
Thinning and roughening of the smooth cartilage that lines the joint surfaces. Gradually occurs with age, but can start early if there is an issue with the shape of the joint. Best managed with exercise to keep strong and mobile along with keeping weight down. More advanced cases may eventually need surgery to replace the joint.
This is where excess bone at the edge of the joint hits the joint itself, damaging the rim of the socket and eventually the cartilage, resulting in early wear and tear. A common cause of hip and groin pain in young adults, especially athletes. This is often addressed with keyhole surgery to reshape the bone and deal with any damage. Highly specialised surgery and I have been fortunate to work with many people on their rehab over the past decade.
These are generally a result of an impingement issue. Often found as we get older and don’t always cause pain, but may need to be repaired with younger adults through keyhole surgery.
Normally seen on the outer edge of the hip. The bursa is a friction-relieving membrane adjacent to tendons. These can become swollen and painful. To fix it you have to allow the bursa to calm down but most importantly address the muscle and tendon issues that will have caused it initially.
Pain in the groin can be due to a weakening or damage of the abdominal wall close to your groin. These problems are frequently overlooked as they can be tricky to spot. We often find these when someone comes in having had many “groin strains” over a long period of time.
Issues with your back can result in pain in the buttock or hip area, even if you don’t actually have back pain. Physio is great for these problems!
The hip is a complicated area with lots of things to consider when trying to determine what the problem is. Rehab is very effective at addressing the underlying issues but sometimes surgery is needed and there have been great advances with this.
Keyhole surgery has been proven to be very effective, especially for young adults with impingement, where the aim is to relieve symptoms and reduce the chance of early wear and tear in the future. When needed, hip replacements are truly remarkable allowing people to get back to painfree exercise and they can last a lifetime (not just ten years as some people still think!). With younger people having hips replaced who want to return to sport and work, the need for better rehab has increased. Just getting back to walking is not good enough for many people and we take great pleasure in helping people get back to the activity and exercise they love.
So don’t put up with annoying “groin strains” and if you’ve had surgery make sure you get the best recovery you can through high quality rehab. Find the issue, address it and move on!